Will a Medicare Supplement (Medigap) Policy Cover Pre-Existing Conditions?

Will a Medicare Supplement (Medigap) Policy Cover Pre-Existing Conditions?

A pre-existing condition is defined as a condition or illness you were diagnosed with, or treated for, before the effective date of a new health insurance policy. You should know that the Medicare Supplement (Medigap) can refuse to cover your pre-existing conditions during the first six months of coverage. This period is known as the waiting period. In other words, you may pass medical underwriting and be enrolled in a Medigap policy, but the pre-existing conditions may delay the coverage of some health problems for up to 6 months. Any claims incurred after six months from the effective date will be covered.

There are two scenarios when the waiting period can be shortened or eliminated: Guaranteed Issue Rights and Open Enrollment Period.

Medicare Supplement Guaranteed Issue Rights and Pre-Existing Conditions

There is no waiting period if you have a Guaranteed Issue Rights when you buy you the Medicare Supplement plan. Whatever your prior medical conditions are, they will be covered immediately under the new policy.

Medicare Supplement Open Enrollment Period and Pre-Existing Conditions

Open Enrollment Period is the best time to apply for a Medicare Supplement policy. By law, the insurance company must accept you for any plan you apply for without medical underwriting. Besides, the waiting period for pre-existing conditions will be shortened by the number of months you had prior creditable coverage. In most cases, health coverage is creditable if there was no break in coverage of more than 63 days.

For example, if you had prior coverage for four months before you enrolled in Medigap, the waiting period will be reduced to 2 months. The previous coverage for six months or longer will result in no waiting period for your pre-existing conditions.

US Government Sources

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